A nurse is leading a grief support group for bereaved clients.
Which of the following client statements should the nurse report to the provider as an indication of clinical depression?

Choice A rationale:

The nurse should not offer advice about various treatment choices to the client who has just received a terminal cancer diagnosis. At this point, the client should be provided with information about available treatment options by the healthcare provider. The nurse's role is to offer support, empathy, and help facilitate communication between the client and the provider. Offering advice about treatment choices is beyond the scope of the nurse's role in this situation.

Choice B rationale:

Discouraging the client from forming new relationships is not appropriate. The client's emotional and psychosocial needs are important, and it's essential to encourage meaningful connections and relationships, especially in a difficult time like receiving a terminal diagnosis. Isolation can have negative effects on the client's emotional well-being, so the nurse should support the client in maintaining relationships.

Choice D rationale:

Changing the subject when the client becomes upset is not an appropriate action. It's important for the nurse to provide emotional support and a listening ear to the client during this challenging time. Changing the subject may come across as dismissive or uncaring, and it does not address the client's emotional needs.

Choice A rationale:

(Statement then rationale) Choice A is the correct option. A blood pH of 7.60 indicates severe metabolic alkalosis, which is a life-threatening condition. Metabolic alkalosis can lead to various complications, including cardiac arrhythmias, muscle weakness, and even seizures. Immediate intervention is required to address the underlying cause and correct the pH imbalance. The nurse should initiate treatments to restore the acid-base balance promptly.

Choice B rationale:

(Statement then rationale) Choice B is not the correct option. While a BUN level of 21 mg/dL is above the normal range, it alone does not require immediate intervention. Elevated BUN can be caused by various factors and may not be immediately life-threatening. It is important to assess the client's overall clinical condition and consider other lab values to make a comprehensive assessment.

Choice C rationale:

(Statement then rationale) Choice C is not the correct option. +2 edema of the lower extremities, while indicating fluid retention, is not an immediate life-threatening condition. Edema should be assessed and addressed, but it does not require emergency intervention as much as a severely altered blood pH does.

Choice D rationale:

(Statement then rationale) Choice D is also not the correct answer. Lanugo covering the body is a physical manifestation often seen in clients with anorexia nervosa and indicates malnutrition. While it is concerning and requires attention, it is not an acute, life-threatening issue. Nutritional rehabilitation and support are needed, but immediate intervention is necessary for the severe metabolic alkalosis indicated by a blood pH of 7.60. Now, let's proceed to the next question.